Lee B M, Yoon S N, Oh C K, Kim J H, Kim S J, Kim H, Shin G T
Department of Surgery, Ajou University School of Medicine, 5 Wonchon-Dong, Yeongtong-Gu, Suwon 443-721, Korea.
Transplant Proc. 2006 Sep;38(7):1974-6. doi: 10.1016/j.transproceed.2006.06.024.
To prevent hyperfiltration of the renal allograft, it is important to initially provide adequate functioning nephrons to meet the metabolic demands of a recipient. During the preoperative evaluation of a potential kidney donor, it is necessary to estimate the renal function of donated kidney compared with the metabolic needs of the recipient. The functional ratio of each kidney was measured using technetium-99m diethylenetriaminepentaacetic acid. The serum creatinine (Scr, mg/dL) and estimated creatinine clearance (Ccr, mL/min/1.73 m(2)) using the Cockcroft-Gault formula were measured and calculated in 82 donors. We excluded recipients who had an episode of rejection, and followed all recipients for more than 6 months posttransplantation. The average functional proportion of the donated kidney was 50.5% +/- 4.7% of the total Ccr 83.4 +/- 18.3 of donors. The Scr of recipients at 1, 3, 6, and 9 months posttransplantation were significantly (P < .05) correlated with the fractional Ccr of the donated kidney; however, Scr at 1 year was not correlated (P = .307). Furthermore, the Ccr of the recipient at 1, 3, and 6 months posttransplantation were significantly (P < .05) correlated with the fractional Ccr of the donated kidney; however, the Ccr at 9 months and 1 year were not correlated (P = .094 and .141, respectively). The Scr and Ccr of recipients within 6 months after transplantation may depend on the functional mass of the donated kidney, which should be estimated prior to kidney donation and compared with the metabolic demands of the potential recipient.
为防止肾移植受者出现高滤过,最初提供足够数量功能良好的肾单位以满足受者的代谢需求非常重要。在对潜在肾供者进行术前评估时,有必要将供肾的肾功能与受者的代谢需求进行比较。使用锝-99m二乙三胺五乙酸测量每个肾脏的功能比率。在82名供者中测量并计算血清肌酐(Scr,mg/dL)以及使用Cockcroft-Gault公式估算的肌酐清除率(Ccr,mL/min/1.73 m²)。我们排除了发生过排斥反应的受者,并对所有受者进行了移植后6个月以上的随访。供肾的平均功能比例为供者总Ccr的50.5%±4.7%(83.4±18.3)。移植后1、3、6和9个月受者的Scr与供肾的分数Ccr显著相关(P<.05);然而,1年时的Scr无相关性(P = 0.307)。此外,移植后1、3和6个月受者的Ccr与供肾的分数Ccr显著相关(P<.05);然而,9个月和1年时的Ccr无相关性(分别为P = 0.094和0.141)。移植后6个月内受者的Scr和Ccr可能取决于供肾的功能量,在肾移植前应进行评估并与潜在受者的代谢需求进行比较。